How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $63.10 Median $93.33 Typical High $181.97 | Facility | None | $63.10 | $93.33 | $181.97 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $72.44 | Professional | None | $63.10 | $63.10 | $72.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $85.11 | Professional | None | $75.86 | $75.86 | $85.11 |
CDPHP Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $64.57 Typical High $114.82 | Facility | None | $57.54 | $64.57 | $114.82 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $407.38 | Professional | None | $77.62 | $77.62 | $407.38 |
Emblem Health Setting Facility Modifier None Typical Low $52.48 Median $77.62 Typical High $177.83 | Facility | None | $52.48 | $77.62 | $177.83 |
Emblem Health Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $89.13 | Professional | None | $77.62 | $77.62 | $89.13 |
Excellus BCBS Setting Facility Modifier None Typical Low $77.62 Median $79.43 Typical High $79.43 | Facility | None | $77.62 | $79.43 | $79.43 |
Excellus BCBS Setting Professional Modifier None Typical Low $77.62 Median $79.43 Typical High $79.43 | Professional | None | $77.62 | $79.43 | $79.43 |
MVP Health Care Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
MVP Health Care Setting Professional Modifier None Typical Low $52.48 Median $70.79 Typical High $70.79 | Professional | None | $52.48 | $70.79 | $70.79 |
United Setting Professional Modifier None Typical Low $75.86 Median $79.43 Typical High $134.90 | Professional | None | $75.86 | $79.43 | $134.90 |
Univera Setting Facility Modifier None Typical Low $77.62 Median $79.43 Typical High $79.43 | Facility | None | $77.62 | $79.43 | $79.43 |
Univera Setting Professional Modifier None Typical Low $77.62 Median $79.43 Typical High $79.43 | Professional | None | $77.62 | $79.43 | $79.43 |
4 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $31.62 Median $31.62 Typical High $36.31 | Professional | 52 · Reduced service | $31.62 | $31.62 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $12.59 Typical High $14.45 | Professional | 53 · Discontinued | $12.59 | $12.59 | $14.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $9.33 Typical High $10.96 | Professional | 55 · Aftercare only | $9.33 | $9.33 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $6.31 Typical High $7.24 | Professional | 56 · Pre-op care only | $6.31 | $6.31 | $7.24 |
Where New York sits
The same service costs 25.1 times more in Alabama than in Nebraska. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
New York· 37th of 51
$75.86
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.